Malone Antegrade Continence Enemas vs. Cecostomy vs. Transanal Irrigation—What Is New and How Do We Counsel Our Patients?
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Purpose of Review
No gold standard exists for managing neurogenic bowel dysfunction, specifically in individuals with spina bifida. Since the International Children’s Continence Society published its consensus document on neurogenic bowel treatment in 2012, an increased focus on why we must manage bowels and how to improve our management has occurred. This review provides updated information for clinicians.
A surge in research, mostly retrospective, has been conducted on the success and satisfaction of three types of management for neurogenic bowel. All three management techniques have relatively high success rates for fecal continence and satisfaction rates. Selection of which treatment to carry out still is debated among clinicians.
Transanal irrigation is a safe and effective management option for neurogenic bowel that does not require surgery. Antegrade enemas can be carried out via cecostomy tube or Malone antegrade continence enema with similar fecal continence outcomes.
KeywordsNeurogenic bowel Spina bifida Fecal incontinence Antegrade continence enemas Cecostomy Transanal irrigation
Compliance with Ethical Standards
Conflict of Interest
Maryellen S. Kelly is on the advisory board for Coloplast A/C.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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